作者：郭雯，上海新東方學(xué)校口譯研究中心成員，口譯教研組閱讀組組長。
博客地址：http://blog.hjenglish.com/guowen

今年高口閱讀第一篇文章是社會(huì)話題，具體的來說，是社會(huì)醫(yī)療福利制度的話題。

本文主題將焦點(diǎn)對(duì)準(zhǔn)“強(qiáng)制醫(yī)療保險(xiǎn)的利與弊”這個(gè)open issue 上，注定了這篇文章以探討為主，作者的觀點(diǎn)會(huì)比較明確，但是解決方案會(huì)比較模糊。本文與新東方口譯課堂上我們?cè)敿?xì)討論過的“美國槍支持有”問題的文章，結(jié)構(gòu)、觀點(diǎn)上都有相同之處。

According to legend, King Canute of Denmark facetiously tried to stop the rising tide by simply raising his hand and commanding the waters to roll back. The tide, of course, kept rising. Yet （主題開始）policymakers throughout history have followed Canute's lead.From Hillary Clinton and John Edwards to Mitt Romney and Arnold Schwarzenegger, politicians across the spectrum have tried or vowed to solve America's health-care woes （主題進(jìn)一步加強(qiáng)）by enacting an individual mandate--a law requiring every adult to purchase health insurance. Despite its bipartisan support, the individual mandate is bad policy, a vain attempt to command a better result while doing nothing to achieve it.

本段承襲高口文章（也是大部分中高級(jí)難度的文章共通的特點(diǎn)）的“鉆石型結(jié)構(gòu)”。即開頭鋪墊，中間主題（就本文來講即雙方觀點(diǎn)碰撞），結(jié)尾補(bǔ)充說明。考生千萬不要被開頭的King Canute 嚇到，這只是一個(gè)丹麥國王，而作者只是在炫耀歷史知識(shí)而已。用普通大眾（頭腦正常的）所不熟知的歷史細(xì)節(jié)嚇唬觀眾，是中外作家的基本功。如果考生能夠循著事實(shí)/論述這個(gè)路子來梳理段落結(jié)構(gòu)的話，不難看出，段落的主題是用一般進(jìn)行時(shí)態(tài)（表示一般性的事實(shí)）表達(dá)出來的。即紅字粗體部分。意思是“決策者經(jīng)常通過普及（強(qiáng)制）個(gè)人醫(yī)療保險(xiǎn)的做法解決醫(yī)療福利問題”。這里讀者應(yīng)該加強(qiáng)閱讀，或者說從這里開始閱讀。在段落結(jié)尾despite提示讀者，作者在加強(qiáng)表達(dá)，順藤摸瓜就能找到bad policy這個(gè)關(guān)鍵的，表示觀點(diǎn)立場(chǎng)的詞匯。

Individual mandate supporters (立場(chǎng)細(xì)節(jié)) typically（明顯的錯(cuò)誤觀點(diǎn)） justify the policy by citing the problem of uncompensated care. When uninsured patients receive health services but don't pay for them, the rest of us end up footing the bill one way or another. So advocates of insurance mandates contend, plausibly enough, that we should make the free riders pay.(錯(cuò)誤觀點(diǎn)的重復(fù)，至此，本段主題確定)

本段主題在開頭結(jié)尾處用supporters引起讀者注意，用typically 暗示這段承襲上段依然是錯(cuò)誤觀點(diǎn)的表述。而這個(gè)錯(cuò)誤觀點(diǎn)在首段的主題處已經(jīng)有所表述，所以，本段在free riders, uncompensated care等處出現(xiàn)生詞的話，可以對(duì)照首段的含義參照理解。這一段是gist+explanation+gist重復(fù)的模式。本段主題為“支持普及醫(yī)療保險(xiǎn)的人認(rèn)為人人皆應(yīng)保險(xiǎn)(should make the free riders pay)”。

But how big is the free-rider problem, really?(作者的觀點(diǎn)很快就要出現(xiàn)了)According to an Urban Institute study released in 2003, uncompen- sated care for the uninsured constitutes less than 3% of all health expenditures. Even if the individual mandate works exactly as planned, that's the effective upper boundary on the mandate's impact. （用讓步關(guān)系強(qiáng)調(diào)作者觀點(diǎn)）

本段加強(qiáng)了上一段的意思，并且作者加入了評(píng)析。從首句可以看出，通過繼續(xù)使用free riders這樣的詞匯，作者暗示出free-riders 問題并未達(dá)到非得用這種極端方式解決的程度。結(jié)尾處說，他們的計(jì)劃最多也不過爾爾。本段的模式是gist + example深入gist 的模式。

OF COURSE, IT WILL NOT WORK exactly as planned. As anyone who has ever driven above 55 mph knows, mandating something is not the same as making it happen. Some people will not comply: 47 states require drivers to buy liability auto insurance, yet the median percentage of uninsured drivers in those states is 12%. Granted, that number might be even higher without the mandates. The point, however, is that any amount of noncompliance reduces the efficacy of the mandate. （of course…but 的結(jié)構(gòu)應(yīng)該很熟悉了）

本段結(jié)構(gòu)同上一段，只是論述更加深入。任何不加入社會(huì)保險(xiǎn)的人都會(huì)使對(duì)方的方案效果減弱，而事實(shí)上，不可能全民皆入保險(xiǎn)。

None of this means the uninsured are not a problem.(作者觀點(diǎn)全部呈現(xiàn)出來: 雙重否定，用來強(qiáng)調(diào)未加入醫(yī)療保險(xiǎn)的公民同樣不可忽視) Yet the true issue isn't that they cost the rest of us too much. It's that they simply get less care than most people (one reason uncompensated care is such a small fraction of health-care spending). And if the real concern is making health insurance and health care available to those in need, we should focus on reducing health-care prices and insurance premiums.The individual mandate is, at best, a distraction from that goal. （仍然不忘進(jìn)行正反觀點(diǎn)的對(duì)比）

本段首句說，雖然全民皆入保險(xiǎn)不可能，對(duì)方的計(jì)劃成為泡影，但是我們?cè)诓煌鈱?duì)方觀點(diǎn)的同時(shí)，也關(guān)注那些不能加入保險(xiǎn)的人們。段尾指出，我們應(yīng)該盡可能幫助這些人加入醫(yī)療保險(xiǎn)，享受保障。但是如果強(qiáng)制全民保險(xiǎn)則南轅北轍。

Some proposals（大眾觀點(diǎn)，永遠(yuǎn)是靶子） couple mandates with subsidies for the purchase of private insurance. As far as policies to encourage more private coverage go, you could do worse. But as long as the public has to subsidize the formerly uninsured, the problem with free riders has not been solved. We're just paying for them in a different way.

To enact any mandate, legislators and bureaucrats must specify a minimum benefits package that an insurance policy must cover. Yet this package can't be defined in any political way. Each medical specialty, from oncology to acupuncture, will push for its services to be included. Ditto other interest groups. In government, bloat is the rule, not the exception.

Even now, every state has a list of benefits that any health-insurance policy must cover--from contraception to psychotherapy to chiropractic to hair transplants. All states together have created nearly 1,900 mandated benefits. Of course, more generous benefits make insurance more expensive. A 2007 study estimates existing mandates boost premiums by more than 20%.

這三段批判了一些其余的社會(huì)觀點(diǎn)，分析了目前各個(gè)州的做法，也提出了一些政府決策的原則。

If interest groups have found it worthwhile to lobby 50 state legislatures for laws affecting only voluntarily purchased insurance policies, they will surely redouble their efforts to affect the contents of a federally mandated insurance plan. Consequently, even more people will find themselves unable to afford insurance.Others will buy insurance, but only via public subsidies. Isn't that just what the doctor didn't order?

這里繼續(xù)指出對(duì)方觀點(diǎn)欠缺的地方，并指出了這樣做的不良后果。這里注意，到此為止，已經(jīng)有了很多不同的，對(duì)于對(duì)方觀點(diǎn)的表述方式：50 state legislatures for laws affecting only voluntarily purchased insurance policies; insurance mandate supporters 等等。

A better approach to health reform would focus on removing mandates that drive up insurance premiums. States ought to repeal some or all of their mandated benefit laws, (推動(dòng)研究加強(qiáng)立法永遠(yuǎn)是作者的解決之道) allowing firms to offer lower-priced catastrophic care policies to their customers. The federal government could assist by guaranteeing customers the right to buy insurance offered in any state, not just their own, enabling patients to patronize companies in states with fewer costly mandates. Indeed, removing mandates would do far more to expand health-care coverage than adding new mandates ever could.